Male infertility specialist in Pune

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Good day bloggers.

The month of March is observed all over the world as an endometriosis awareness month. While reading many recent journals for updates, and guidelines, we were getting updated about numbers, the gravity of endometriosis and the challenges ahead of us.

While being in clinical practice where every patient is unique and the symptoms appear to be as diverse as non-menstrual abdominal or pelvic pain, Infertility, Painful sex, or bowel-related symptoms, Bladder pain along with Lower back pain, Bloating, and consistent fatigue.

Endometriosis may be at the root of all of these symptoms, sometime in silent form or may be intense in the future and as the disease may present in different ways in different individuals. Unbearable pain is a constant complaint in the above cases.

Very difficult to diagnose based on a few scans and tests along with silence to bear with situations makes it hard for all. We are here to put the concerns of endometriosis beyond assumptions.

Let us find out more about endometriosis.

What is endometriosis?

ENDOMETRIOSIS is a condition where endometrial tissues and adhesions are found outside of the uterus and these cells respond to hormonal changes as if, they are within a uterus. such cells may be found in the bladder, pelvic region and bowel and other organs too. Such lesions of endometriosis get attached to other organs too. Such conditions then can cause intense pain as well as inflammation.

Endometriosis is not a period disease.

Unlike during regular periods, the pain of endometriosis isn’t caused by contractions of the uterus, but instead, comes from uterus tissue growing elsewhere in the pelvic cavity. This inflammation often results in a lot of pain. The intense pain from endometriosis can occur regularly, even in the absence of a menstrual cycle. Menstrual pain can be managed with over-the-counter pain killers whereas endometriosis pain is severe and may not be managed with over-the-counter painkillers alone. Period pain is labelled as dysmenorrhea and goes away after the periods.

It is a spectrum disease with a variety of subtypes and symptoms like pain, inflammation, infertility, development of endometriomas (“chocolate cysts”), fibrosis, formation of adhesions (fibrous bands of dense tissue), Gastrointestinal and other organ dysfunction, and much more, are common with endometriosis.

Detection of endometriosis takes time:

The real reason behind this lengthy detection is symptoms which are many and every patient may have different complaints. The silence kept over the symptoms often causes a delay in seeing an expert. To understand endometriosis, let us know about symptoms which cannot be ignored and can help to seek the help of an expert.

Symptoms often reported but not limited to are,

Pelvic Pain in the abdomen, Painful intercourse and sexual activity, Leg pain, lower back pain etc. Most of the time, symptoms appear to be on the surface and are mild. As time passes, lesions go deeper and chronic symptoms become noticeable. Does it mean, every symptom is of endometriosis? No. Rather, put it like this. We need to know, what is normal and what not so normal or causing concern is. Watch out for the symptom intensity, duration, frequency, medication response, and symptoms’ reoccurrence. Make a note of it and keep it handy as it can form the basis of the right history taking.

So, when should you go to the doctor?

If the pain is severe and comes days before the period and persists after the period, then it could be endometriosis. See a gynaecologist and get tested. Another indication is if the pain doesn’t go away after taking painkillers or other analgesic pills, or over the period, intensity, duration & episodes increase with time.

Endometriosis is certainly not in your head, and we hear your silence.

Let’s understand that pain has intensity and every individual has a different tolerance capacity. That is why we at Pearl Women’s hospital understand your pain and developed a protocol to address your concerns. We understand pain as an obstacle that affects your daily routine and needs prompt treatment.

Endometriosis slowly and steadily takes over the body, intensity increases over time. You may be scaling new highs on the personal as well as professional front while being with endometriosis. Gold standard Laparoscopic examination may confirm the diagnosis and we understand, not all illnesses are visible and still be powerful to affect lives.

Let the silence be deleted and let’s practically know more about endometriosis.

Endometriosis is rare, what is your take?

Endometriosis is not rare as there is 10% of women suffer from it, which means 1 out of 10 women suffer from it.

Endometriosis is now a commonly diagnosed condition in gynaecology and you are not alone. The cases like PCOS and uterine fibroids are widely seen and spoken about but with endometriosis, the case is different. As there is no defined biomarker or blood test which can reveal endometriosis, its severity and progression. It simply does not mean, there is no progress in understanding disease in depth. There are multidisciplinary approaches to reducing effective symptoms.

After detection and with a surgical approach, can endometriosis be cured?

Currently, there is no cure for endometriosis, there are treatments available to reduce the symptoms and their intensity. The key whole surgery is still major surgery. There are multiple options available to control symptoms like medications, IUDs, surgeries, Pelvic floor physiotherapy, Prescription pain killers, supplements etc.

Your treatment plan will be tailor-made as per your conditions and may not be identical to others,

Be gentle to yourself. It ok, if you are not performing at your best sometimes.

Let’s understand some facts in a nutshell

As of now, Endometriosis has no cure but effective treatments are available which offer relief.

Endometriosis is a chronic, systemic inflammatory disease.

Treatment for endometriosis is not the same or one size fits all approach.

Pregnancy is not a cure for endometriosis

Birth control can offer temporary relief.

The right diagnosis at right time is the key which helps in the faster and more effective treatment

The silence over endometriosis is a matter of concern

A lot needs to be done and the least we can do is, seek the guidance of the right doctor.

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Abnormal uterine bleeding (AUB) is a common gynaecological complaint associated with considerable morbidity and significantly affects the patient’s family, personal and social life. Abnormal uterine bleeding is the medical term for abnormalities in the frequency, volume, duration, and regularity of the menstrual cycle & occurs in absence of pregnancy.

It is a common gynaecological complaint accounting for one-third of outpatient visits to a gynaecologist. It is caused by a wide variety of organic or non-organic causes. An organic cause is a term used to describe any health condition in which there is an observable and measurable disease process, such as inflammation or tissue damage.

Non-organic causes are the one that shows the symptoms but whose disease process is either unknown or unable to be measured by current scientific means.

To understand better, let’s talk about, what is normal bleeding. This is appropriate for reproductive-age women (menarche to menopause), with bleeding occurring every 21 to 35 days, lasting 3-7 days, and a blood flow of 35 ml.

Bleeding from the vaginal area between periods is one of the signs of this illness. Extremely excessive bleeding during periods can also be caused by abnormal uterine haemorrhage. Menorrhagia is a condition that arises when severe bleeding continues for more than 7 days during periods or otherwise.

Polyps or fibroids, which are abnormal growths in the uterus, can cause AUB. AUB can also be caused by a cervical infection, a thyroid condition, or uterine cancer, among other causes. Hormone imbalance is also the known cause of heavy bleeding.

The disorder is called dysfunctional uterine haemorrhage when abnormal bleeding develops as a result of hormone imbalance. Dysfunctional uterine haemorrhage is more common in teenagers and women approaching menopause.

Treatment for abnormal uterine bleeding is determined by the patient’s age, the reason of the bleeding, and whether or not she wishes to become pregnant in the future. The different treatment options include the use of an intrauterine device, birth control pills, D&C (dilatation and curettage), endometrial ablation and hysterectomy.

There are many causes for abnormal uterine bleeding and that exactly defines the difference between abnormal uterine bleeding and dysfunctional uterine bleeding.

In both cases, menstrual bleeding and related symptoms exist but the causes are different. In case of dysfunctional uterine bleeding, it is directly linked to hormonal imbalances.

Intrauterine device (IUD): An intrauterine device (IUD) is a tiny plastic device that is put into a woman’s uterus through the vaginal canal. Hormones released by the IUD assist to prevent irregular bleeding.
Using birth control pills: They prevent the lining of the uterus from getting too thick & help to regularize the menstrual cycle and even reduce cramping.
D&C or dilatation and curettage procedure: The opening of the cervix is expanded so that a surgical instrument may be put into the uterus in the D&C or dilatation and curettage process. With the use of this instrument, the uterine lining is scraped away. The doctor then checks the removed lining for any abnormality and determines the cause of the abnormal bleeding. D&C is used to identify the source of bleeding.
Hysterectomy: It is a surgical treatment that involves the removal of the uterus. It prevents the patient from having any further periods and from becoming pregnant. It is normally performed under general anaesthesia and requires a person to stay at a hospital.
Endometrial ablation: This treatment removes the uterine lining rather than the uterus itself. As a result of the surgery, all forms of monthly bleeding are stopped.
Simple measures to cope up with: Abnormal uterine bleeding which arises as a result of any abnormality in the menstrual cycle and is most common. In the vast majority of cases, it can resolve itself without the need for therapy. Self-care methods and home remedies can also aid with the condition’s treatment.

The use of menstruation cups is one example of a lifestyle modification.
Use of heating pads which can ease the symptoms like abdominal cramps and severe pain.
Using period panties, for dry pad feeling, which offer sleep comfort.
Proper and adequate rest, Adequate hydration
Breathing exercises and yoga are good examples of regular exercises. These have a calming effect.
Consumption of adequate iron, vitamin C, and other minerals and vitamins supplements.
Even when a person can manage their heavy flow, it is still best to consult a doctor, who will investigate and identify any underlying issues. This can assist to lessen the flow’s intensity and duration. The menstrual bleeding disorder has a impact on other bodily functions. Right diagnosis &treatment is the key.
Take home points: Irrespective of any age group, menstrual disorders should not be taken lightly proper medical diagnosis & treatment not only offer relief but also reduce the future complications if any.

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Fertility changes with age. In women, this is very conspicuous and the window period of fertility is much smaller than in men. Males & Females attain fertility with the onset of puberty. For girls, fertility begins with the onset of ovulation and menstruation and ceases with the onset of menopause. Women can no longer conceive naturally after menopause, according to common belief.

In today’s scenario, age-related infertility is more common due to various reasons. Many women prefer to concentrate on a career for financial security and wait until their 30s to begin their families. Women take care of themselves better, so are far healthier & more updated about information available.

In general, women’s reproductive potential declines as they age, and fertility usually ends 5 to 10 years before menopause.

During their reproductive years, women have regular monthly menstrual periods because they ovulate regularly monthly. Eggs mature inside fluid-filled spheres in the ovaries – called “follicles.” When a woman has her period at the beginning of her menstrual cycle, a hormone released in the pituitary gland (located in the brain) promotes a number of follicles on both ovaries to develop faster. The pituitary hormone that stimulates the ovaries is named FSH (FSH). Normally, only one of those follicles will reach maturity and release an egg (ovulate); the remainder gradually will stop growing and degenerate. Pregnancy results if the egg gets fertilized and gets attached to the lining of the uterus. If pregnancy doesn’t occur, the endometrium is shed because conception hasn’t occurred and we say that the cycle has begun again.

In their early teens, girls often have irregular ovulation leading to irregular menstrual cycles, but by age 16 they ought to have established regular ovulation leading to regular periods. From 26 to 35 days, a woman’s periods will be regular until her late 30s or early 40s, when they will get shorter. As time passes, she is going to begin to skip ovulation leading to missed periods.

Ultimately, periods get prolonged or become infrequent until they cease completely. When a lady has not had a menstrual period for 1 full year, she is claimed to be in menopause. Fertility falls as women age due to natural, age-related changes in the ovaries. A woman is born with all of the egg-containing follicles in her ovaries that she will ever have, unlike men, who continue to produce sperm throughout their lives.

At birth, there are about one million follicles. By puberty – about 300,000. Only around 300 of the follicles left at puberty will be ovulated during the reproductive years. The majority of follicles are not used up by ovulation and are eventually lost due to atresia, a degenerative process that happens independently of a woman’s condition, such as pregnancy, normal periods, being on birth control pills, or being treated for infertility. Menopause appears to occur one year earlier in smokers than in non-smokers.

In her 20s, a woman’s reproductive years are at their maximum. Fertility gradually declines within the 30s, particularly after age 35. A healthy, fertile 30-year-old woman has a 20% chance of becoming pregnant each month she tries. That means that just 20 out of every 100 fertile 30-year-old women who try to conceive in one cycle will succeed, with the remaining 80 having to try again. By age 40, a woman’s chance is smaller than 5% per cycle, so fewer than 5 out of each 100 women are expected to achieve success monthly.

Women do not remain fertile until menopause. The average age for menopause is 47, but most women cannot have successful pregnancies in their mid-40s. These percentages are true for natural conception also as conception using fertility treatment, including in vitro fertilization (IVF).

Much misleading information is spread through the media, which often misinterprets the age impact and an attempt is made to make patients believe that fertility treatments such as IVF are the easiest way to get pregnant. The natural process of conception, as well as assisted techniques for pregnancy, are greatly affected by age. Great nutritional status, as well as the solid foundation of financial security, does not reverse the biological clock.

The success rate of infertility treatments is affected by a woman’s age. The age-related loss of female fertility happens because both the standard and therefore the number of eggs gradually decline.

Unlike a woman’s first reduction in fertility, a man’s sperm characteristics fall considerably later. Sperm quality deteriorates as men age, although it usually does not become a problem until a guy is in his 60s. Changes in fertility and sexual functioning do occur in men as they get older.

Despite these changes, the ability to father a child even in the 60s and 70s with a younger partner is possible

Men’s testes decrease and get softer as they age, and sperm morphology (shape) and motility (movement) tend to indicate no. There is a slightly higher risk of genetic defects of sperms, happening during DNA fragmentation.

Any illness like diabetes, BP adversely affect their sexual and reproductive function. Not all men, especially those who maintain their health over time, have major changes in reproductive or sexual functioning as they age.

Improved health status does not interfere with the natural age-related decline in fertility. It’s critical to realise that a woman’s fertility decreases as she ages due to the natural decrease in the amount of eggs left in her ovaries as she ages. This decline may happen much before most girls expect.

While addressing infertility age is the main contributing factor. There are other contributing factors like ovulation disorders, hormonal imbalances, tubal defects, varicocele, infection & uterine fibroids to name a few.

ENDOMETRIOSIS: BEYOND SYMPTOMS AND ASSUMPTIONS

Abnormal Uterine Bleeding (AUB): Healthy Womb & Happy You Series

Treatment Options Available for AUB:

Natural Ways to Reduce the Troubles Associated with Abnormal Uterine Bleeding?

FERTILITY IN THE AGING MALE & FEMALE

SIGNIFICANCE OF OVULATION AND THE MENSTRUAL CYCLE IN FERTILITY

FERTILITY IN THE AGING FEMALE:

FERTILITY IN THE AGING MALE: